A Note to Insurers: Address the Pain Prescription Opioid Abuse Problem

Recent press coverage highlights the work of congressional representatives and key opinion leaders to impact insurance carrier policy with respect to nonopioid and abuse deterrent opioid treatment alternatives for pain. Senator Joe Manchin (D-W.Va.) recently sent a letter to the CEOs of UnitedHealth...

Opioid Overdose Vaccine: Helping the Substance Use Disorder Epidemic

New research presented last week at the national meeting of the American Chemical Society may point the way to a more effective treatment response for overdoses of opioid combinations—including fentanyl combined with heroin--that are at the heart of the epidemic of substance use disorder. The new...

The Challenge of the Inherited Pain Patient

In addition to other shortcomings, current prescribing guidelines are particularly ill-suited to the needs and challenges of patients already on opioid therapy. Drs. Heit and Gourlay discuss the roots of the problem and the role of primary care as talented amateurs in addiction medicine.

Women and Substance Abuse: It's More Than Just Opioids

American women who are pregnant or of reproductive age and use opioids for nonmedical reasons are also likely to use other substances including nicotine, alcohol, and/or cocaine, according to an analysis conducted at University of Pittsburgh School of Public Health. The study is described as the...

Addiction Medicine: Helping Patients with Substance Use Disorders

Senior PAINWeek faculty member Douglas Gourlay, MD, MSc, FRCPS, FASAM, has spoken often of the need for frontline practitioners with an interest in pain to become “talented amateurs” in addiction medicine. A new consensus document released by the American Society of Addiction Medicine (ASAM) may...

The Dilemma of Postoperative Pain in High Risk Patients and Addiction

A news story and accompanying article appearing last week, and authored by National Public Radio correspondent Craig Lemoult, highlights the problem of postoperative pain management in high risk patient populations. The story details the tragic death last December of 23-year-old Max Baker, a...

New Drugs of Abuse: Not for Human Consumption

It's important for practitioners to be "in the know" about drugs of abuse, whether new ones, or new abuses of well-known drugs.

Decreasing and Managing Pain Patient Aberrant Behavior

Practitioners routinely wrestle with the issue of medication aberrant behavior (MAB)--What should I do about this? Should I discharge the patient? Will I get in trouble if I don't discharge this patient? Often there is no one right answer, and practitioners struggle with what to do in the face of a...

A Primer for Chronic Pain Management and Substance Abuse Disorders

The field of pain management has undergone a circuitous adventure, much like a rabbit hole. As the economic, mental health, and medical consequences of prescribing opioid medications have mounted, the prevailing logic regarding the usefulness of prescribing opioids for chronic pain has shifted. The...

Clinical Pearls of Drug Testing Case Studies

The science of drug testing in chronic pain has advanced rapidly over the past few years. Yet there is still confusion around optimal test choices, frequencies, and what test results actually provide. Today's definitive drug testing technology can help to identify more than the simple "presence or...